Reasons for risk practices of injected drug users involved in harm reduction programs in Barcelona

Despite the high coverage of harm reduction programs in Barcelona, injected drug users
(IDUs) continue to maintain risk-taking practices. The analysis of these practices from the
perspective of drug users is a key to guide health education interventions from harm reduction
services. The objective of this study is to know the reasons of the IDUs for risk consumption
practices. An ethnographic study was carried out between 2012 and 2016 through participant
observation in five harm reduction centers and semi-structured interviews with 15 IDUs. Data
content analysis was performed. The IDUs believe mistakenly that some consumer tools, such
as the filter or citrus, serve to remove impurities or pathogens from the substances. They inject
themselves in high-risk areas and pump the blood repeatedly with the expectation of obtaining
more intense effects. They hold a fragmentary knowledge about the routes of transmission
of HIV and hepatitis. They do not know some determinants of overdoses and have a partial
knowledge of how to react in case of it. These risky consumption practices are attributed
to erroneous and partial knowledge of prevention, physical deterioration, and stigmatization
processes among IDUs. It is recommended to increase action in health education from harm
reduction programs involving meaningful participation of drug users who carry out peer education
strategies for better adaptation and credibility in preventive messages.